Spousal recollections of early signs of primary progressive aphasia

Pozzebon, Margaret; Douglas, Jacinta; Ames, David

doi:10.1111/1460-6984.12347

Cited by 18 publications

(43 citation statements)

References 40 publications

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“…Finally, early changes in social cognition were identified as a feature of all 3 variants of PPA by the spouses in Pozzebon et al's investigation. 28 The theme of lack of awareness of PPA was also identified in the family member studies. The participants in Pozzebon et al, 28 which focused on spousal experiences during the early stages of PPA, frequently reported not understanding what their spouses were experiencing or why symptoms were occurring.…”

Section: Experiences Of Living With Ppa From the Perspective Of Familmentioning

confidence: 96%

“…26 A thematic analysis of the findings from the family member studies revealed 6 themes: observing and adapting to language, behavioral, and social communication changes; lack of awareness of PPA; control; the impact of the historical relationship; dealing with loss and grief; and support. The theme of observing and adapting to language, behavioral, and social communication changes included family members noticing linguistic changes in their relatives with PPA, with 4 of the investigations 22,26,27,28 revealing findings about the family's experiences of behavioral and social communication changes in their relatives. For example, in the Pozzebon et al investigation, 27 the wife of an individual with svPPA noticed that the insidious onset and progression of the disorder dramatically changed her husband's personality and his interactions with her.…”

Section: Experiences Of Living With Ppa From the Perspective Of Familmentioning

confidence: 99%

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Experiences of Living With Primary Progressive Aphasia: A Scoping Review of Qualitative Studies

Davies

Howe

2019

Am J Alzheimers Dis Other Demen

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Introduction: Understanding the experiences of people who live with primary progressive aphasia (PPA) can inform the development of appropriate speech-language pathology services for this population. This review aimed to summarize the qualitative research on the experience of living with PPA from the perspective of the individuals with the disorder and their families. Methods: A scoping review was conducted. Results: Eight studies met the inclusion criteria. Themes in the 3 investigations that focused on the individual’s perspective included adapting to overcome language difficulties and dealing with increased dependency. Themes identified in the 5 studies that highlighted the family’s perspective included observing and adapting to language, behavioral, and social communication changes; lack of awareness of PPA; control; and the impact of the historical relationship. Discussion: Experiences from the 2 perspectives differed. Further research is needed, particularly in relation to identifying the general experience of PPA from the perspective of individuals with the disorder.

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Section: Experiences Of Living With Ppa From the Perspective Of Familmentioning

confidence: 96%

Section: Experiences Of Living With Ppa From the Perspective Of Familmentioning

confidence: 99%

Experiences of Living With Primary Progressive Aphasia: A Scoping Review of Qualitative Studies

Davies

Howe

2019

Am J Alzheimers Dis Other Demen

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“…Clinical and carer reports further corroborate these findings, with the majority of LPA patients presenting with visible extra-linguistic general cognitive difficulties ( Owens et al , 2018 ). Further, changes in socioemotional, attention and memory functions in LPA are detectable 1–3 years prior to spousal recognition of frank expressive language difficulties in patients ( Pozzebon et al , 2018 ). Together, these findings argue against language dysfunction as the sole mediator of general cognitive decline in LPA and suggest the presence of genuine co-occurring non-linguistic cognitive deficits.…”

Section: Introductionmentioning

confidence: 99%

Establishing two principal dimensions of cognitive variation in logopenic progressive aphasia

Ramanan

Roquet

Goldberg

et al. 2020

Brain Communications

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Logopenic progressive aphasia (LPA) is a neurodegenerative syndrome characterised by sentence repetition and naming difficulties arising from left-lateralised temporoparietal atrophy. Clinical descriptions of LPA largely concentrate on profiling language deficits, however, accumulating evidence points to the presence of cognitive deficits even on tasks with minimal language demands. Although non-linguistic cognitive deficits in LPA are thought to scale with disease severity, patients at discrete stages of language dysfunction display overlapping cognitive profiles, suggesting individual-level variation in cognitive performance, independent of primary language dysfunction. To address this issue, we used principal component analysis to decompose individual-level variation in cognitive performance in 43 well-characterised LPA patients who underwent multi-domain neuropsychological assessments and structural neuroimaging. The principal component analysis solution revealed the presence of two, statistically independent factors, providing stable and clinically intuitive explanations for the majority of variance in cognitive performance in the syndrome. Factor 1 reflected ‘speech production and verbal memory’ deficits which typify LPA. Systematic variations were also confirmed on a second, orthogonal factor mainly comprising visuospatial and executive processes. Adopting a case-comparison approach, we further demonstrate that pairs of patients with comparable Factor 1 scores, regardless of their severity, diverge considerably on visuo-executive test performance, underscoring the inter-individual variability in cognitive profiles in comparably ‘logopenic’ patients. Whole-brain voxel-based morphometry analyses revealed that speech production and verbal memory factor scores correlated with left middle frontal gyrus, while visuospatial and executive factor scores were associated with grey matter intensity of right-lateralised temporoparietal, middle frontal regions and their underlying white matter connectivity. Importantly, LPA patients with poorer visuospatial and executive factor scores demonstrated greater right-lateralised temporoparietal and frontal atrophy. Our findings demonstrate the inherent variation in cognitive performance at an individual- and group-level in LPA, suggesting the presence of a genuine co-occurring cognitive impairment that is statistically independent of language function and disease severity.

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“…Clinical and carer reports further corroborate these findings, with the majority of LPA patients presenting with visible extra-linguistic general cognitive difficulties (Owens et al, 2018). Further, changes in socio-emotional, attention, and memory functions in LPA are detectable 1-3 years prior to the onset of frank expressive language difficulties (Pozzebon et al, 2018). Together, these findings argue against language dysfunction as the sole mediator of general cognitive decline in LPA and suggest the presence of genuine co-occurring non-linguistic cognitive deficits.…”

Section: Introductionmentioning

confidence: 57%

Establishing two principal dimensions of cognitive variation in Logopenic Progressive Aphasia

Ramanan

Roquet

Goldberg

et al. 2019

Preprint

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Running title: Distinct cognitive profiles in LPA Word count (abstract): 394 words Word count (manuscript): 6,258 words Number of tables (manuscript): 3 Number of figures (manuscript): 5 Total number of display items (manuscript): 8 Supplementary material: 1 supplementary file with supplementary methods, tables, and figures Number of tables (supplementary): 4 Number of figures (supplementary): 4ABSTRACT Logopenic Progressive Aphasia is a neurodegenerative syndrome characterised by sentence repetition and naming difficulties arising from left-lateralised temporoparietal brain atrophy.Mapping of the clinical phenomenology of this syndrome has largely concentrated on its language deficits. Accumulating evidence, however, points to the presence of cognitive deficits, even on cognitive tasks with minimal language demands. Traditionally, nonlinguistic cognitive deficits in Logopenic Progressive Aphasia have been thought to scale with advancing disease severity. When grouped according to the severity of language dysfunction, however, subgroups of Logopenic Progressive Aphasia frequently display overlapping cognitive profiles, suggesting individual-level systematic variation in nonlinguistic cognitive performance that may be independent of primary language dysfunction.To address this issue, we used principal component analysis to decompose variation in cognitive performance at an individual level, in a large, well-characterised cohort of Logopenic Progressive Aphasia patients (N = 43). Patients underwent detailed, standardised neuropsychological assessments of language, memory, executive and visuospatial functioning, in addition to structural neuroimaging. The principal component analysis solution revealed the presence of two, statistically independent factors, providing stable and clinically intuitive explanations for the majority of variance in cognitive performance in the syndrome. Factor 1 reflected 'speech production and verbal memory' deficits which typify Logopenic Progressive Aphasia. Systematic variations were also confirmed on a second, orthogonal factor mainly comprising visuospatial and executive processes -domains previously thought to be affected later in the disease stage. Adopting a case-comparison approach, we further demonstrate that pairs of patients with comparable speech production and verbal memory factor scores, regardless of their severity, diverge considerably on visuoexecutive test performance, underscoring the inherent inter-individual variability in cognitive profiles in comparably 'logopenic' patients. Whole-brain voxel-based morphometry analyses revealed that speech production and verbal memory factor scores correlated with left middle frontal gyrus, while visuospatial and executive factor scores were associated with grey matter intensity of right-lateralised temporoparietal, middle frontal regions and their underlying white matter connectivity. Importantly, Logopenic Progressive Aphasia patients with poorer visuospatial and executive factor scores demonstrated greater right-lateralised temp...

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Spousal recollections of early signs of primary progressive aphasia

Abstract: Understanding the nature of symptoms perceived in the earliest stages of PPA has potential to inform earlier and accurate diagnosis and interventions to assist those living with the illness.

Cited by 18 publications

References 40 publications

Experiences of Living With Primary Progressive Aphasia: A Scoping Review of Qualitative Studies

Experiences of Living With Primary Progressive Aphasia: A Scoping Review of Qualitative Studies

Establishing two principal dimensions of cognitive variation in logopenic progressive aphasia

Establishing two principal dimensions of cognitive variation in Logopenic Progressive Aphasia

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